Cumplimiento ex ante (presupuesto)/ex post (ejecución presupuestaria) de la meta

3. Strategy

Vision and values

3.1 Our mission is the improvement of health and the alleviation of pain, suffering and sickness for the people we serve.

3.2 We will achieve this through providing high quality, cost-effective and integrated healthcare with compassion and through the constant quest for new treatment strategies and the development of the people who work for us.

3.3 Our core values are Excellence, Compassion, Respect, Delivery, Learning and Improvement.

3.4 Collaboration and partnership are central to our approach in delivering our triple functions of patient care, education and research.

3.5 Summarised as ‘Delivering Compassionate Excellence’, our values are being used by staff and leaders throughout our organisation and with partner organisations as a basis for improving the quality of the care we provide, not least in terms of our patients’ experience of care.

3.6 These values determine Oxford University Hospitals NHS Trust’s (OUH’s) vision to be:

at the heart of a sustainable and outstanding, innovative academic health science system, working in partnership and through networks locally, nationally and internationally to deliver and develop excellence and value in patient care, teaching and research within a culture of compassion and integrity. 3.7 This vision is underpinned by the Trust’s founding partnership with the University of Oxford.

3.8 It reflects OUH’s position as a provider of healthcare for local people and for a wider population. 3.9 The patient is at the heart of everything the Trust does. OUH is committed to delivering high quality

care to patients irrespective of age, disability, religion, race, gender and sexual orientation, ensuring that its services are accessible to all but tailored to the individual.

3.10 Central to the Trust’s vision are its staff. OUH aims to recruit, train and retain the best people to enact its values and achieve its vision.

3.11 OUH strives for excellence in healthcare by encouraging a culture of support, respect, integrity and teamwork; by monitoring and assessing its performance against national and international standards; by learning from its successes and setbacks; by striving to improve what it does through innovation and change; and by working in partnership and collaboration with all the agencies of health and social care in the area it serves.

3.12 The Trust is committed to being an active partner in healthcare innovation, research and education. It aims to be an effective bridge between research in basic science and healthcare provision, turning today’s discoveries into tomorrow’s care through the use of evidence-based, best practice.

3.13 OUH’s vision and values inform its strategic objectives which in turn form the basis of this Integrated Business Plan.

Strategic objectives

3.14 The Trust has six strategic objectives from which its priority work programmes flow.

SO1. To be a patient-centred organisation providing high quality, compassionate care with integrity and respect for patients and staff – “delivering compassionate excellence.”

SO2. To be a well-governed organisation with high standards of assurance, responsive to members and stakeholders in transforming services to meet future needs – “a well-governed and adaptable organisation.”

SO3. To meet the challenges of the current economic climate and changes in the NHS by providing efficient and cost-effective services and better value healthcare – “delivering better value healthcare.”

SO4. To provide high quality general acute healthcare to the people of Oxfordshire including more joined-up care across local health and social care services – “delivering integrated local healthcare.”

SO5. To develop extended clinical networks that benefit our partners and the people they serve. This will support the delivery of safe and sustainable services throughout the network of care that we are part of and our provision of high quality specialist care for the people of Oxfordshire and beyond – “excellent secondary and specialist care through sustainable clinical networks.”

SO6. To lead the development of durable partnerships with academic, health and social care partners and the life sciences industry to facilitate discovery and implement its benefits – “delivering the benefits of research and innovation to patients.”

Strategic

objectives

Delivering compassionate excellence A well-governed and adaptable organisation Delivering better value healthcare Delivering integrated local healthcare Excellent secondary and specialist care through sustainable clinical networks Delivering the benefits of research and innovation to patients

Measures of strategic success

3.15 OUH is committed to improve and develop its services for local people. These ‘local acute’ services are vital to each of the Trust’s triple functions of patient care, education and research.

3.16 Developments in ‘local acute’ services are described in Chapter 5 and reflect a clear and constructive response to local demographic change and to the needs faced by local commissioners.

3.17 OUH Executive and Divisional Directors have met with Oxfordshire CCG’s six locality groups to strengthen relationships, share respective strategies, discuss issues of shared concern, consider locality-specific issues and discuss how meaningful engagement can be maintained. A proposed work programme is being considered by the Trust’s Board in July 2013. The Trust is also working with Oxfordshire County Council’s Director of Public Health to support the development of a public health strategy for the county which can help guide the development of the services OUH provides for the people of Oxfordshire. The Trust also recognises a need to work closely with GPs as providers of care. It participates in Oxfordshire Local Medical Committee’s liaison group and has invited Oxfordshire LMC to nominate a Governor to the Trust’s Council of Governors (see 3.82.1 below). 3.18 During the period of this IBP, distinct changes can be expected in the models of care delivery in which

OUH is involved. Integration of care supported by rapid access to expertise will underpin the Trust’s services for local people and especially for older and vulnerable adults. OUH is strengthening its clinical liaison with local GPs as it develops improved and new models of local acute care.

3.19 Similar principles support the development of the Trust’s specialist services, with a developing network of clinical partners beginning to shape a future where OUH is a partner with a range of providers in delivering high quality and effective care as locally as possible. Chapter 5 describes developments which support and strengthen the value and sustainability of its specialist services. 3.20 Progress against OUH’s strategic objectives will be manifested in several ways for different groups:

• For patients, through levels of satisfaction and experience that compare well with those of comparable teaching trusts. Patients will experience excellent care delivered in accordance with OUH’s values. Patients receiving ‘general hospital’ care will benefit from better-integrated care closer to home. Across a wider clinical network, patients will be able to access specialised care more locally. Overall, the Trust’s patients will benefit from the results of translational research and gain early access to evidence-based treatments and care pathways.

• For staff, through raised levels of satisfaction and skills development. Staff will benefit from working in a supportive culture where, consistent with OUH’s values, individuals are treated with integrity and respect. Opportunities for personal development will be enhanced through new roles and ways of working, particularly through involvement with research and engagement across both the Oxford Academic Health Science Centre, the wider Consortium and the Oxford Academic Health Science Network.

• For the trust’s public members who will have the opportunity to influence the Foundation Trust and to be involved with its development.

• For commissioners who will be able to access better value healthcare. OUH plans to reshape its services to increase efficiency, enhance quality and where necessary to reduce hospital activity. 3.21 OUH will also measure its success in several other ways:

• Through choice by referrers to use OUH, seen through activity levels demonstrating sustained market share and new patterns of referral for specific services;

• By creating a clinical network with continued collaboration and partnership;

• In the Oxford Academic Health Science Network, through partnership with a strong commitment to deliver the benefits of innovation for patients;

• In the Oxford Academic Health Science Centre, through partnership with a strong commitment to the translation of basic research into applied research and patient services;

• Through innovation in service delivery, with recent examples including a supportive hospital discharge service delivering social care, and the introduction of a psychological medicine service; • By benchmarking, through demonstrating that the Trust delivers patient safety, patient

experience, outcomes and costs that compare well with available comparators; and

• Through evidence of delivery against plans, reinforcing confidence in the organisation’s capability.

Organisational building blocks

3.22 Delivery of OUH’s strategic objectives is founded on organisational building blocks which represent important developments in how it operates. These are:

Board leadership

• Strong and visible leadership across all areas and specifically in terms of values and strategic development;

• Focus on quality and patient experience at the highest level; and • Leadership within the local and wider health community.

Clinical leadership

• Day-to-day management and delivery of services by clinically-led Divisions; and • Development of the strategic future for the Trust founded on Divisional involvement.

Staff engagement, wellbeing and development

• Use of a behavioural framework to support the application of the Trust’s values in practice; and • An education and training framework to underpin the Trust’s workforce strategy.

Governance and assurance

• Improved systems at directorate, Divisional and trust level to provide assurance to the Board and to regulators of the quality of care and effective systems for the avoidance of harm; and

• Incorporation of learning from other healthcare organisations.

Value for money

• Maximising the service quality and clinical outcomes delivered through a defined resource via visibility of costs at patient level;

• Divisions operating as strategic business units for delivery of service and workforce redesign, informed by benchmarking; and

• Delivery of a divisionally-owned and corporately-supported programme to improve outcomes and reduce costs on a rolling two-year basis.

Enabling strategies

• Progress is supported by OUH’s Estate and Workforce strategies. Also relevant are the Trust’s strategies for Quality, Information Management & Technology, Membership, Risk and Assurance.

Strategic Objective 1: “Delivering Compassionate Excellence”

3.23 This objective is rooted in three of the Trust’s core values and is embedded in its everyday activities. It commits the Trust to the principle of shared-decision making, putting patients at the centre of all that it does.

3.24 Work derived from addressing this objective includes that on learning and development for the clinical workforce. The development of sustainable and patient-focused establishments in wards, theatres and clinics with robust clinical leadership intended to maintain and improve quality whilst containing cost through minimising use of agency and bank staff, is explicitly linked to the Trust’s values. Likewise, OUH’s work to improve governance, assurance and information systems all support the delivery of the best care.

3.25 Following a process of engagement with staff and the Trust’s Patient Panel in autumn 2011, OUH agreed values for use in recruitment, appraisal, training and personal development of its staff and in leadership and management development. The enactment of these values is taking place through initiatives described in 8.65.

3.26 The Trust is developing its mechanisms for gathering and using patient feedback and has a programme of board walk rounds so that Board members are in touch with the views and experience of patients. A scheme based on the concept of “You said… We did…” is intended to demonstrate responsiveness to patients’ views.

3.27 The monitoring and benchmarking of outcomes assists the Trust in maintaining a quality focus across its services. Progress is reflected in the Quality Account.

3.28 As well as the attitude of its staff towards its patients, the Trust’s ambition to deliver compassionate excellence also reflects the culture to be nurtured in the organisation more widely, with the ethos of integrity and respect amongst staff and in dealings with partners in the delivery of care. OUH aims to engender a culture that expresses commitment and pride in the quality of care it provides, whilst monitoring and assessing performance to provide supportive challenge and to learn from its successes and setbacks and those of others.

Strategic Objective 2: “A Well-Governed and Adaptable Organisation”

3.29 Authorisation as an NHS Foundation Trust will support the achievement of OUH’s mission, vision and strategic objectives. Becoming an FT is not an end in itself but a means of creating a clinically and financially sustainable organisation with strong and effective governance arrangements.

3.30 OUH seeks to respond imaginatively to the challenges posed by the economic environment. Operating as an FT will allow the rapid adoption of new ways of working, with greater scope for the delivery of new forms of care in new settings. The potential to use a range of business models with commercial, academic, health or social care partners, individually or in combination, will allow the Trust to provide better value care for the patients of tomorrow in new ways.

3.31 OUH will operate within the context of a clearly stated strategy over several years. It employs a governance framework designed and assessed through external scrutiny as fit to support its delivery and underpinned by appropriate Risk Management and Assurance strategies. Through the Trust’s membership and Council of Governors, OUH’s patients, public, staff and partner organisations will play a part in guiding this strategy.

3.32 OUH will take steps to ensure meaningful engagement with minority groups and those representing the nine protected characteristics, ensuring that through its membership and the Council of Governors, the communities it serves are able to influence the future of its services.

3.33 Patients will experience care provided by an organisation where they can influence service change and be closely involved in innovation and development from ever-stronger links with world-class research and teaching through the NIHR-funded Oxford BRC and BRU, the Oxford Academic Health Consortium and the Oxford Academic Health Science Network.

3.34 The Trust will grow its membership and, through its Membership Strategy, fulfil its social responsibility as a major local employer and provider of services.

3.35 OUH’s systems and processes – from electronic patient records to quality governance – are continuing to develop to respond flexibly and meet emerging standards.

Strategic Objective 3: “Delivering Better Value Healthcare”

3.36 The Trust will continue to change the way it operates to deal with the tensions between the increasing demand for healthcare, both in terms of scale and complexity, and the limitations to the growth of financial resources. It will focus on the value of its healthcare and use innovation to enhance this for the services it offers. This means developing and delivering flexible and sustainable models of care, improving performance against a range of benchmarks and making use of opportunities that exist to make savings from infrastructure.

3.37 Increased value for money is the result of improved outcomes and quality of services linked to improved cost effectiveness in their delivery. Achievement will draw on research already underway on self-care and the use of e-health technologies.

3.38 The Trust is committed to providing high-quality and efficient secondary care services for its local population and to growing its tertiary care services where there are benefits to be gained for patients and commissioners through sharing expertise and costs. Potential developments in cancer services to provide these benefits are described in Chapter 5.

3.39 Some elements of efficiency improvement are linked to the Trust’s estate strategy, implementing inter-site service moves between the four hospital locations to make the best use of modern facilities and enable out-of-date property to be vacated, especially on the Churchill Hospital site.

3.40 OUH intends to reshape how its services are delivered in order to achieve the twin goals of improved care and greater efficiency. This will include maximising the use of its physical resources, enabling it to function within a smaller footprint and to close inefficient and time-expired property. This will be achieved by providing more continuous and uninterrupted care and timely access to diagnostics and theatres through enhanced weekend and extended-day working. These changes are intended to enhance patient experience and cost-effectiveness

3.41 Work to strengthen and rationalise out-of-hours site cover across the Trust’s hospitals also reflects the improvement of patient safety and value for money.

Strategic Objective 4: “Delivering Integrated Local Healthcare”

3.42 The delivery of high quality healthcare to Oxfordshire’s local population is a key focus and responsibility for OUH and requires a flexible and imaginative response to the challenge of managing the growing needs of older patients, those with long-term conditions and those with multiple co- morbidities.

3.43 The Trust is strengthening its work with local GPs to inform a programme of service change that will transform a range of services delivered primarily (though not entirely) for the people of Oxfordshire. 3.44 OUH will redesign its local services, especially in acute medicine, to ‘design out’ unnecessary and

potentially harmful extended stays in hospital and put in place a model of care that is clinically and financially sustainable. This means changing the model of care in particular for vulnerable, older

people by offering more integrated care closer to home, applying acute clinical expertise in the non- hospital setting and ‘right-sizing’ the Trust’s inpatient capacity. Such an approach will result in services that are more responsive to patients’ needs, as well as being more cost-effective. This is consistent with the NHS Operating Framework for 2012/13 which emphasises the need for more service delivery to be integrated and organised around the interests of patients.

3.45 The nature and scale of this challenge requires innovative approaches to provide the necessary expertise and care in out-of-hospital settings. The Trust has already begun delivering social care through its Supported Discharge service as part of a package of schemes to deliver acute medical care beyond the hospital site, to allow a safe and sustained reduction in use of inpatient care. This will contribute to reducing delays and fragmentation of care.

3.46 In order to deliver the required level of improvement, the Trust is working in partnership with agencies in the local health and social care system and contributing to a multi-agency action plan on these shared issues. Developments are described in Chapter 5. OUH’s work will aim to improve the experience of patients and clinicians at the interface between primary and secondary care.

3.47 Within its hospitals, especially the John Radcliffe and Horton General, OUH will reshape its ‘local acute’ services, introducing systems to rapidly provide patients with relevant specialist input once their immediate emergency needs have been met. By doing so, patients and GPs will experience the benefits of care coordinated by OUH specialists and thereby the benefits of treatment by an organisation with a wide range of expertise that can be applied quickly to meet assessed needs. 3.48 OUH will work closely with local commissioners as plans develop for the integration of maternity care

for Oxfordshire and for the development of integrated care for frail older people.

In document PROPUESTAS PARA PERFECCIONAR LA REGLA FISCAL (página 60-63)